title: Minimally invasive approach for coronary artery bypass surgery.
abstract: Forty-two patients, 33 male and 9 female, aged 35.7 to 81.6 years old (mean 62.7), were operated on for left main and/or triple vessel coronary artery disease by using minimally invasive cardiac surgical techniques. A myocardial infarction had occurred in 26 patients (61.9%). The left ventricular ejection fraction ranged from 17 to 83% (52+/-22). The surgeries were performed through left parasternal minithoracotomy (8 to 12 cm in length) under femoro-femoral or aorto-atrial cardiopulmonary bypass. The myocardium was protected by blood cardioplegic solution with the aorta crossclamped. Under direct vision, average 3.8 distal anastomoses were performed in each patient, with the saphenous vein grafts and the left internal thoracic arterial graft. The aortic crossclamp time was 62 to 137 min (80+/-15). The duration of cardiopulmonary bypass was 88 to 168 min (115+/-24). The postoperative course was uneventful in all patients. Follow-up (1.0 to 5.6 months, mean 2.9) was complete in all patients and there were no late deaths or angina. Coronary angiography of ten patients showed patent grafts. Our experience demonstrates that minimally invasive cardiac surgery during cardioplegic arrest is technically feasible and can be performed in coronary artery disease safely and effectively for complete revascularization.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan.
authors.forename: Y C
authors.initials: YC
authors.lastname: Wu
authors.forename: C H
authors.initials: CH
authors.lastname: Chang
authors.forename: P J
authors.initials: PJ
authors.lastname: Lin
authors.forename: J J
authors.initials: JJ
authors.lastname: Chu
authors.forename: F C
authors.initials: FC
authors.lastname: Tsai
authors.forename: M W
authors.initials: MW
authors.lastname: Yang
authors.forename: P P
authors.initials: PP
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000175:diagnosis / Q000601:surgery*; D004452:Echocardiography; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012501:Saphenous Vein / Q000637:transplantation; D013895:Thoracic Arteries / Q000637:transplantation; D013908:Thoracotomy / Q000379:methods; D016896:Treatment Outcome; D014654:Vascular Patency